Safety Program Evaluation Form

ELEMENT 1—MANAGEMENT COMMITMENT

1. A written policy that sets a high priority for safety exists.

An effective policy will be both informative and directive. It will express a commitment to safety and the intent of the company to carry out the policy.   A written policy will clarify expectations. The policy will be accessible to all employees. “Safety First” is meaningful only if management doesn’t re-prioritize or eliminate safety initiatives when the going gets tough. Prioritizing safety may  also send the message that employees must choose either safety or production, not both. Safety is considered a corporate value and is not prioritized over production.

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2. Written safety goals and supporting objectives exist.

Each of the seven safety program elements should contain specific goals and supporting objectives.

Objectives should be: (1) measurable, (2) observable, and (3) completed within a time frame. For instance, a safety goal might be to “Increase employee involvement in safety.” A supporting safety objective would be “Complete joint supervisor/employee job hazard analyses on all jobs in East Dallas facility by July 30th, 2001.”

Written plans containing goals and objectives are better able to communicate purpose and function clearly. Consequently, duties, responsibilities, criteria, specifications, and expectations will be more effectively met in a consistent manner throughout the entire organization.

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3. Management supports the workplace safety policy.

What does that support look like? Support needed for an effective safety and health program must include a substantial commitment to safety. Top management commitment must go beyond lip service. Effective safety management is more than moral support or talking up safety. Management needs to invest serious time, money, and effort into proactive safety initiatives.

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4. Management supports safety goals and objectives.

Management and labor jointly establish safety goals and objectives. If the primary safety goal is “zero accidents,” management will establish objectives to achieve that goal. One objective to reach this goal might be “Train all employees on proper lifting techniques by December 30, 2017.” Management will then support this objective by developing an effective system for training and accountability.

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5. Management supports safety health rules.

Management best supports safety and health rules by educating all employees on those rules and insisting that everyone, at all organizational levels, follow those rules. Management must also provide everyone with the resources necessary for compliance.

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6. Managers personally follow safety rules.

Management cannot expect employees to follow safety rules if they do not. If supervisors and managers ignore safety rules, they actually “rewrite” those rules. Actions always speak l ouder than words.

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7. Managers personally intervene in the safety behavior of others.

Supervisors and managers acknowledge and personally intervene when they see an employee engaged in unsafe behaviors. They stop the unsafe behavior, find out why it occurred, and do whatever it takes to make sure it doesn’t happen again.

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8. Managers set a visible example of safety leadership.

Management and leadership are not the same. Management is an organizational skill. Leadership is a human relations skill. Leaders establish positive relationships with their followers. Opportunities for safety leadership exist at all levels. The greater the responsibility, the more opportunity exists to demonstrate safety leadership. Effective safety programs maximize opportunities for safety leadership. Safety leaders send very powerful and important messages to others when they, themselves, set a good example. Setting a good example is accomplished through action. Safety leaders genuinely care about employees’ safety and success on the job.

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9. Managers participate in the safety training of employees.

Involving supervisors in the safety training process is smart business. A policy of involvement supports the principle and communicates to supervisors that it’s their job to manage safety as well as production. Employees will more likely perceive safety as an important area of accountability when supervisors are directly involved in safety training.

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ELEMENT 2—LABOR AND MANAGEMENT ACCOUNTABILITY

10. Management enforces safety rules.

Safety is required, not encouraged. Enforcing safety rules requires management to: (1) establish clear standards, (2) provide the resources to achieve those standards, (3) devise a fair system of measurement against those standards, (4) administer appropriate consequences, and (5) consistently apply accountability throughout the company-both top down and laterally.

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11. Safety program tasks are each specifically assigned to a person or positions for performance or coordination.

Line managers clearly understand their obligation to perform the daily responsibilities for safety as well as production. The safety committee and the safety officer coordinate in a

consultative role. Without specific safety assignments and responsibilities, accountability becomes very difficult.

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12. Each assignment of safety responsibility is clearly communicated.

Formal written responsibilities clearly assign safety responsibilities. All employees are aware of their workplace safety responsibilities.

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13. Individuals with assigned safety responsibilities have the necessary knowledge, skills, and timely information to perform their duties.

Individuals have the proper education and training which qualifies them to perform their safety responsibilities. Systems are in place to measure individual knowledge and skills.

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14. Individuals with assigned safety responsibilities have the authority to perform their duties.

Accountability follows control or authority. Supervisors and managers generally have control/authority over the physical conditions in their workplace. They have the authority to successfully carry out their assigned safety responsibilities, provide resources, educate and train, recognize, discipline, etc. Employees assume responsibility for adherence to expected safety behavior.

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15. Individuals with assigned safety responsibilities have the resources to perform their duties.

The employer recognizes that managers and employees depend on others to provide the resources necessary to carry out their safety responsibilities. Systems have been developed to provide necessary resources to labor and management, which will allow them to adhere to established safety standards of behavior and performance.

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16. An accountability mechanism is included with each assignment of safety responsibility.

Safety responsibilities assigned to each manager, supervisor, and employee are tied to appropriate consequences. If the employee fails to meet established standards, consistent, fair corrective actions are administered. If the employee meets or exceeds those standards, positive recognition occurs. Remember the four R’s: If you Regularly Recognize, you’ll Rarely have to Reprimand.

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17. Individuals are recognized and rewarded for meeting safety responsibilities.

Recognition: Expression of appreciation for a job well done is always appropriate. It provides an opportunity for leadership. Recognition should: (1) occur soon after the behavior, (2) be certain employees know they will be recognized, and (3) be significant and sincere, genuine expression. Effective recognition can be accomplished privately or publicly.

It’s most effectively thought of as a function of leadership, not management. It’s personal. Recognition does not always include reward.

Reward: A reward system must be developed thoughtfully and carried out carefully and fairly or it will fail. Rewards can become entitlements if not properly managed. Any reward system should not discourage injury and accident reporting.

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18. Individuals are held accountable for not meeting safety responsibilities.

Corrective actions are effectively administered and the end result is a positive, characterbuilding experience for the employee. Success in this element depends on the approach of the leader. Accountability is not punitive in nature. Its intended purpose is to increase discipline doing the right thing all the time. It should also help to improve character by making the right decision when no one is watching. If not appropriately carried out, corrective actions will create a more negative relationship between the manager and employee.

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19. Supervisors know whether employees are meeting their safety responsibilities.

Management adequately supervises or oversees the work their employees are doing. Supervision is adequate when hazardous conditions and unsafe behaviors are being effectively detected. Supervision is effective when injuries and illnesses are prevented.

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ELEMENT 3—EMPLOYEE INVOLVEMENT

20. There is a process designed to involve employees in safety issues.

Employees must be involved for the safety program to flourish. The more involved employees are in the process, the more ownership they will have. When employees believe they own a process, they will value it. Management has developed a system that invests time and money in employee involvement in safety. The system includes and encourages involvement in safety education, membership in the safety committee, making safety suggestions, and communication.

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21. Employees know how to become involved in the safety process.

Employees have been educated about the various ways they may be involved in safety. When asked, employees know who their safety committee representative is. They understand safety suggestion program procedures. They participate in job hazard analyses.

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22. Employees believe the process that involves them in safety issues is effective.

Safety is perceived as a positive system. Employees believe the process is effective and the safety and health system operates in a culture of safety leadership. Managers, supervisors, and employees all express leadership by not only doing the right things, but also by doing the right things right. Managers provide resources, recognize, correct, and set a proper example. The safety committee identifies and evaluates, provides useful information, and makes effective recommendations.

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23. The workplace safety policy is effectively communicated to employees.

When asked, employees are able to answer questions about the workplace safety policy. Policy is communicated formally through written statements and presentations. Policy is communicated and reinforced informally through what managers say and do daily.

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24. Employees support the workplace safety policy.

Employees at all levels of the company are involved in some or all of the elements of the safety program. They support the policy by carrying out their safety responsibilities without oversight or reminders.

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25. Safety goals and supporting objectives are effectively communicated to employees.

When asked, employees are able to correctly answer questions about the workplace safety goals and objectives. Goals and objectives are communicated formally in writing and during educational classes. They are communicated informally through what managers say and do daily.

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26. Employees support safety goals and objectives.

Employees at all levels of the company are involved in planning and carrying out safety goals and objectives. They are supporting goals and objectives by carrying out their related safety responsibilities.

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27. Employees use the hazard reporting system.

Employees understand and feel comfortable using the company’s hazard reporting system.

Employees report hazards to their supervisors and/or safety committee representatives.

Reporting hazards in the workplace is encouraged and considered professional behavior.

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28. Injury/illness data analyses are reported to employees.

Injury and illness data is posted where employees have easy access. The safety committee reviews this and other statistical data on a regular basis to identify trends and corrective actions.

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29. Hazard control procedures are communicated to potentially affected employees.

A system to educate and train affected employees on safety programs such as Lockout/Tagout, Hazard Communication, Bloodborne Pathogens, etc., is in place. When asked, employees are able to correctly answer questions about hazard control procedures that affect them.

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30. Employees are aware of how to obtain competent emergency medical care.

When asked, employees are able to correctly answer questions about how to respond to a workplace emergency. A system is in place to educate and train all employees on emergency procedures and how to obtain emergency medical care.

Notes and rationale for rating: _________________________________________________________

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ELEMENT 4—HAZARD IDENTIFICATION AND CONTROL

31. A comprehensive baseline hazard survey has been conducted within the past five years.

Comprehensive surveys that evaluate the entire facility should be periodically conducted. Baseline surveys are important workplace activities that identify, analyze, and evaluate the current status of:

  • Safe/unsafe or hazardous conditions. This may include such things as chemical inventories, machine guarding, housekeeping, and exposure to noise and hazardous atmosphere levels. Hazardous conditions represent the surface causes for accidents.
  • Safe/unsafe work practices. Through observation and interviews, the degree of safe employee and management-level behaviors is assessed and evaluated. Unsafe behaviors also represent the surface causes for accidents. Hazardous conditions and unsafe practices are really the symptoms of deeper root (system) weaknesses.
  • Safety program elements. Analysis and evaluation of the seven safety system elements determine how effective current safety and health policies, programs, plans, processes, and procedures are. These represent the root causes that have allowed surface causes to develop and exist. Always evaluate systems in your comprehensive baseline survey.

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32. Effective job hazard analysis (JHA) is performed, as needed.

In this process, the supervisor, in conjunction with the safety manager and an employee representative, work together to analyze the task the worker performs. The worker is observed performing the task. Next, the task is broken down into steps. Each step is jointly assessed to identify any conditions and practices that might cause an injury or illness. Means and methods to eliminate identified hazards are jointly developed. If necessary, procedures are revised to make the task less hazardous. The supervisor, safety manager, or safety committee use the process to uncover the system’s weaknesses related to the hazards found during the JHA.

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33. Effective safety and health inspections are performed regularly.

Everyone is involved in the inspection process. Line workers inspect their workstations daily. Supervisors inspect their sections as often as necessary, depending on the nature of the hazards. Managers in conjunction with supervisors conduct inspections of their operations on a scheduled basis and jointly analyze/evaluate the safety systems in place that affect their operations.

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34. Effective surveillance of established hazard controls is conducted.

Once workplace hazards are corrected, a system is in place to make sure they stay corrected. A periodic safety committee inspection process is used to monitor the workplace to ensure corrective actions are permanently established. Employee involvement in this process is also evident.

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35. An effective hazard reporting system exists.

Hazard reporting is a mandated activity. It is a professional behavior that is expected from every employee. Some questions to ask in evaluating this item include:

  • Are employees actually reporting hazards?
  • To whom are they reporting hazards? The safety committee representative? The immediate supervisor? Both? Most effectively, supervisors should get the report so that they can take immediate corrective action.
  • Do employees feel comfortable reporting hazards? The more comfortable they are, the more trust they are displaying in management.
  • Are reports called “complaints”? Reporting hazards is considered a “best practice” that saves lives and money.
  • Are employees being recognized and possibly rewarded when they report hazards?
  • Remember, employee behavior reflects the expected consequences.
  • Are reporting procedures simple? The less complicated, the more effective the response.

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36. A safety analysis is performed whenever a change in facilities, equipment, materials, or processes occurs.

Any change in the workplace may introduce hazardous conditions and/or unsafe work practices. A system is in place to make sure that safety is considered in all phases of the change process. A formal safety analysis can serve as an excellent guide in performing such an analysis.

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37. Expert hazard analysis is performed, as needed.

Outside experts are used to help identify and control hazards in the workplace. Management understands that using private consultants to perform objective hazard analysis is smart business and may result in greatly reduced accident costs.

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38. Hazards are eliminated or controlled promptly.

When hazards are reported, a system to promptly correct them is in place. The longer it takes to identify and correct hazards, the greater the probability of an accident. A successful system has been established where supervisors are directly accountable for making sure hazards are corrected promptly.

The safety committee and management have developed a prioritized schedule for correcting hazards. The more serious the hazard, the more quickly it is corrected.

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39. Hazard control procedures demonstrate a preference for engineering methods.

Three approaches to hazard control are used:

  • Engineering Controls. The best method is to eliminate the hazard. Although this is called an “engineering” control, you do not have to be an engineer to successfully apply this method. Two conditions must be present for an accident to occur: (1) the hazard, and (2) exposure to the hazard.

Engineering controls address the first condition. Hazards are “engineered out” through initial design, redesign, substitution, enclosure, etc. You are changing the “thing” (tool, equipment, machinery, facility) to eliminate the hazard. If the hazard is successfully eliminated, the exposure to that hazard is also eliminated.

  • Administrative Controls. Standard Operating Procedures, Standard Practice Bulletins, Work Instructions, or other procedural controls attempt to “administrate out” the exposure to the hazard through safe work practices. You are changing the behaviors and actions (process, procedure). You’re not addressing the hazard itself, but only the exposure to the hazard.

Administrative controls are effective only as long as workers follow established safe procedures.

  • Personal Protective Equipment (PPE). PPE sets up a barrier between the worker and the hazard. It does not eliminate or reduce the hazard. This method is usually applied in conjunction with administrative controls. Again, it’s important to understand that, as with administrative controls, this method will be successful only to the degree that workers follow established procedures.

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40. Effective engineering controls are in place, as needed.

Regular workplace surveys are conducted, by both employees and management, to make sure tools, equipment, and machinery are properly guarded and that wherever possible, those hazards are controlled by engineering methods. Engineering controls are effective if they: (1) do not result in less efficient operation of the equipment, (2) are able to prevent an injury or illness at all times, even when the worker is distracted, and (3) protect employees from environmental hazards.

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41. Effective administrative controls are in place, as needed.

There is a process in place to evaluate whether or not administrative controls are effective and ensure that managers and workers are displaying appropriate behaviors. Administrative controls change the way things are done in the workplace. They include employee job rotations, exercise programs, procedural changes, and breaks.

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42. Safety and health rules are written.

Written safety and health rules clarify required safety behaviors to everyone in the company. Written safety rules also include the reasons why the rule exists and why it’s important to follow. Rules are tied to accountability.

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43. Safe work practices are written.

Written safety policies, plans, and procedures addressing safe work practices for each department have been developed and distributed. The Job Hazard Analysis is incorporated into the development of safe work practices.

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44. Personal protective equipment is effectively used as needed.

Employees and management recognize that effective use means 100 percent use. Effective PPE use is achieved because many safety systems are already working properly. Employees are given effective education and training, and they are working within a culture of safety accountability. Management is not “encouraging” PPE use when its use is required.

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45. Effective preventive and corrective maintenance is performed.

A program to ensure that tools, equipment, and machinery operate properly so that unexpected starts, stops, or breakdowns do not occur has been developed. The program provides for adequate scheduling and reporting. If tools, equipment, or machinery fail or become defective, they are corrected as soon as possible to prevent an injury. Faulty equipment and machinery that could cause a serious injury or fatality is taken immediately out of service. Maintenance work orders that correct hazards are identified as unique from other work orders so they do not end up at the bottom of a stack of work orders. A quickresponse corrective maintenance program, with provisions to expedite safety work orders, has been developed and incorporated into the preventive and corrective maintenance program.

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46. Emergency equipment is well maintained.

Emergency equipment is adequate for its intended purpose. Fire extinguishers, personal protective equipment, chemical spill containment equipment and materials, and other emergency equipment are inspected regularly, properly positioned, and replaced or repaired when necessary.

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47. Engineered hazard controls are well maintained

An adequate inspection and maintenance schedule is in place to verify that hazard control systems are properly maintained so that they continue to eliminate or reduce exposure to hazards that might cause injury or illness. Ventilation systems, machine guards, enclosures, and guardrails are examples of engineered hazard controls.

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48. Housekeeping is properly maintained.

Effective housekeeping is a daily effort by everyone to make sure clutter is eliminated. Proper training, continual inspection, and quick removal of clutter ensure that the workplace is clean and organized.

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49. The organization is prepared for emergency situations.

A comprehensive plan has been developed to address all emergency scenarios. The company makes sure the emergency action plan or emergency response plan is in place and exercised regularly. If the workplace contains confined spaces, an emergency rescue plan is also required. If workers perform tasks at elevation, emergency rescue procedures are in place and employees are trained.

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50. The organization has an effective plan for providing competent emergency medical care to employees and others present at the facility.

Effective written plans convey information about the importance of the program and who is responsible for carrying out program responsibilities. This information is posted and readily available to all management and employees. When asked, management and employees are able to communicate their responsibilities under the plan. Posted information is updated as often as is necessary.

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51. An early return-to-work program is in place at each facility.

Management is committed to the concept of early-return-to-work. Employees return to work as soon as possible, and participate in productive work, not make-work. The program assigns health-provider-approved modified duties to employees. Whatever the employee does, the nature of the work is not perceived as punitive.

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ELEMENT 5—INCIDENT AND ACCIDENT INVESTIGATION

52. Incidents/accidents are investigated for root causes.

When incidents and accidents are investigated (analyzed for cause, not blame), the investigator uncovers both the surface and root cause(s) that represent underlying weaknesses in the system. Faulty tools, equipment, machinery, or management and worker behaviors are surface causes. Underlying or root causes are weaknesses in the system that allowed the unsafe condition or act to occur. Inadequate or missing policies, processes, or procedures are system weaknesses that could represent root causes.

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ELEMENT 6—EDUCATION AND TRAINING

53. An organized safety and health training program exists.

Safety is totally integrated into operations training. Because safety is an important component in the delivery of quality service, it is considered too important to be taught separately from operations. Line management is directly involved in training safety procedures. Supervisors and trusted mentors train employees. Safety is not solely delegated to a training staff. Management communicates the company’s high standards and insists that all employees meet those standards.

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54. Employees receive safety and health training.

Safety training occurs before an employee is exposed to any new hazard. Appropriate times for training include new employee orientation, change of job assignment, and before the introduction of new equipment, materials, or procedures. Training documentation that certifies an employee’s understanding, abilities, and skills is maintained.

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55. Employee training covers hazards of the workplace.

New employee training includes the general hazards that might be encountered during the course of work. Once the new employee is assigned to a particular department, he or she receives additional education and training about the specific hazards of the workstation and area. JHAs are used as a valuable training tool. (See statement 32.)

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56. Employee safety and health training covers all Safe Work Practices subjects.

The company’s Safe Work Practices encompass many of the training requirements for dayto-day operations. A formal plan has been developed to ensure that all required initial and refresher training as well as training to address new hazards is conducted.

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57. Employee training covers the facility safety system.

All employees are introduced to and have a sound understanding of the company’s Safety System Plan and the various elements within that plan. They are encouraged to make suggestions for system improvement, and to be involved in safety committee activities.

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58. Appropriate safety training and education is provided to every employee.

Each employee is educated and trained. Safety education creates a positive safety attitude by ensuring that the employee understands why a safety rule, procedure, or requirement is important. Safety training helps the employee develop the needed abilities and skills to use safety equipment or perform a procedure.

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59. New employee orientation includes applicable safety and health information.

A management representative discusses the company’s commitment to safety as a core value to new employees. Job security depends more on working safe than working fast. Safety policies, programs, and rules are discussed and employees are told why these policies, programs, and rules are important. New employees are introduced to their safety committee representative during orientation.

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60. Employees understand workplace safety policies.

Management makes sure they really know if employees understand safety policies by asking questions and observing them. Employees are able to answer questions to the manager’s satisfaction and are observed complying with policy.

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61. Employees understand safety and health goals and objectives.

Employees participate in goal setting. They know what the goals are and are involved in carrying out objectives.

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62. Employees periodically practice implementation of emergency plans.

The following emergency plans are examples of those that should be practiced as often as required or necessary:

  • Emergency response plans (medical emergencies, fire, and earthquake).
  • Chemical release and evacuation.
  • Confined space rescue.
  • Fall rescue.

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63. Employees are trained in the use of emergency equipment.

Training includes demonstration to make sure all employees have the skills required to use the equipment. Drills are critical and should be performed on a regularly scheduled basis.

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64. Supervisors receive safety and health training.

Management at all levels attends safety and health education and training. Supervisors and managers are knowledgeable and skilled in managing safety programs, including recognition and corrective actions.

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65. Supervisors receive all training required by OSHA standards.

Several Safe Work Practices have mandatory training components. A partial list includes:

  • Hazard communication
  • Forklift operation
  • Confined space rescue
  • Bloodborne pathogens
  • Respirators

Refer to OSHA standards for more information on training requirements.

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66. Supervisors are effectively trained on all applicable hazards.

Supervisors are proficient in their knowledge of the hazards and safety procedures required in their departments.

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67. Supervisors are trained on all site-specific preventive measures and controls relevant to their needs and supervisory responsibilities.

Supervisors have sufficient knowledge of preventive measures and know how to use effective hazard control strategies. They also have the skills and authority to effectively eliminate or reduce hazards and unsafe behaviors.

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68. Supervisor training covers the supervisory aspects of their safety and health responsibilities.

Supervisors are trained on safety regulations and site-specific hazards. Supervisors also have the knowledge and organizational skills necessary for effective safety management. These skills include training, conducting safety meetings, inspecting facilities and operations, enforcing policy and rules, and correcting hazards and unsafe actions.

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69. Managers are expected to attend safety and health training.

Managers at all levels have appropriate and ongoing education and training in occupational safety and health management. Managers understand the means and methods of their operations and can provide necessary resources to their supervisors.

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70. Managers are aware of all relevant safety and health training mandated by external regulations or internal policies.

A survey or interview with managers and supervisors will assist in evaluating this item.

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71. Managers understand the organization’s safety and health system.

A survey or interview with managers and supervisors will assist in evaluating this item.

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72. Relevant safety and health aspects are integrated into all management training.

Managers understand the big picture. They understand that safety is a “profit center” activity, and know how to effectively support the safety system. They receive education about their legal, fiscal, and moral obligations as managers and leaders to the law, stakeholders, and society at large.

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ELEMENT 7—PERIODIC PROGRAM REVIEW

73. Workplace injury/illness data are effectively analyzed.

Accident and illness reports, safety committee minutes, and baseline surveys are assessed to determine the presence/absence of hazards. They are also analyzed to discover trends and to determine the effectiveness of related safety systems.

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74. The effectiveness of safety training is regularly evaluated.

At the conclusion of training, employee knowledge of the subject is measured through oral or written exams. Ability and skill is measured by requiring the employee to demonstrate a task or procedure.

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75. Post-training safety knowledge and skills are regularly tested or evaluated.

Interviews, surveys, and observation are used to determine knowledge, skills, attitudes, and safety behaviors. The information gathered from these evaluation methods is used to determine how effective safety training is and where improvements may be needed.

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76. Hazard incidence data is effectively analyzed.

Incident reports, hazard reports, and data is gathered and analyzed to better reach conclusions about how to correct underlying system weaknesses that may be allowing them to exist. There is a well-trained safety committee that conducts this evaluation as a continuous effort.

Notes and rationale for rating: _________________________________________________________

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77. Hazard controls are monitored to assure continued effectiveness.

Everyone is involved in monitoring hazard controls in the workplace, not just the safety section or safety committee. Employees and supervisors are directly involved in this activity.

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78. A review of in-place company mandated programs is conducted at least annually.

An effective review of the safety culture and system is conducted no less than annually. Periodically, an outside expert is brought in to bring another perspective to the review.

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